Antibiotic combination-associated nephrotoxicity in granulocytopenic patients with cancer.
Antibiotic combination-associated nephrotoxicity was reviewed in 491 granulocytopenic patients with cancer and fever. Nephrotoxicity was defined as a rise in the serum creatinine level of more than 0.4 mg/dL. The different aminoglycosides, when combined with ticarcillin disodium, were found to have an equivalent nephrotoxic potential and, for the purpose of analysis, were combined and termed "aminoglycoside plus ticarcillin" (Ags + ticarcillin). Groups treated with gentamicin or amikacin plus cephalothin sodium were combined and termed "aminoglycoside plus cephalothin" (Ags + cephalothin). The rate of nephrotoxicity was statistically less for the Ags + ticarcillin group, eight (3.1%) of 262 patients, than for the Ags + cephalothin group, 23 (18.3%) of 126 patients. Age greater than 50 years was a potentiating factor for the occurrence of nephrotoxicity in the Ags + cephalothin group. We have concluded that for granulocytopenic patients with cancer and fever, the antibiotic combination of the Ags + cephalothin should not be used as empiric antibiotic therapy.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000380:Agranulocytosis / Q000150:complications*; D000617:Aminoglycosides / Q000008:administration & dosage / Q000009:adverse effects; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002512:Cephalothin / Q000008:administration & dosage / Q000009:adverse effects; D002986:Clinical Trials as Topic; D003404:Creatinine / Q000097:blood; D004359:Drug Therapy, Combination; D006801:Humans; D017053:Infection Control; D007674:Kidney Diseases / Q000139:chemically induced* / Q000150:complications; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D011897:Random Allocation; D013982:Ticarcillin / Q000008:administration & dosage / Q000009:adverse effects
D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D003404:Creatinine; D013982:Ticarcillin; D002512:Cephalothin